Rhinocerebral Mucormycosis in the Era of Lipid-Based Amphotericin B: Case Report and Literature Review

• Published in: Pharmacotherapy Vol. 22; no. 4; pp. 519 - 526
• Main Authors: Mondy, Kristin E., Haughey, Bruce, Custer, Philip L., Wippold II, Franz J., Ritchie, David J., Mundy, Linda M.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-04-2002; Pharmacotherapy
• Subjects: Amphotericin B - therapeutic use; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antifungal agents; Antifungal Agents - therapeutic use; Biological and medical sciences; Female; Humans; Lipids - therapeutic use; Medical sciences; Middle Aged; Mucormycosis - diagnosis; Mucormycosis - drug therapy; Mucormycosis - surgery; Pharmacology. Drug treatments; Sinusitis - diagnosis; Sinusitis - drug therapy; Sinusitis - surgery; Human; Nervous system diseases; Mycosis; Drug carrier; Complex lipid; Long term; Cerebral disorder; Infection; Case study; Mucormycosis; Antifungal agent; Chemotherapy; Treatment; Amphotericin B; Polyenic compound; Central nervous system disease; Dosage form
• ISSN: 0277-0008; 1875-9114
• DOI: 10.1592/phco.22.7.519.33679

Rhinocerebral mucormycosis (RCM) is an invasive fungal infection that necessitates, in most cases, aggressive surgical debridement and high cumulative, often nephrotoxic doses of amphotericin B. A 50‐year‐old woman with RCM was treated successfully with amphotericin B lipid complex as primary therapy. The patient previously had displayed progressive intracranial involvement and rising serum creatinine levels while receiving the conventional (nonlipid) form of amphotericin B. A literature review identified only a few cases where systemic antifungal therapy was administered, with minimal or no surgery. Our case further supports that amphotericin B lipid complex can be used as primary therapy in selected patients with RCM, without the need for surgical exenteration.